摘要
目的探讨血小板/淋巴细胞比值(PLR)对数字减影血管造影(DSA)引导下肺癌患者经外周静脉置入中心静脉导管相关上肢静脉血栓(PICC-UEVT)的预测价值。方法选取2022年1月至2025年2月江苏大学附属高淳医院收治的160例肺癌患者。根据PICC-UEVT的发生情况,将患者分为血栓组(36例)和非血栓组(124例)。构建受试者工作特征曲线评估PLR对DSA引导下肺癌患者PICC-UEVT的预测价值。采用多因素Logistic回归分析DSA引导下肺癌患者PICC-UEVT的影响因素。结果血栓组患者血小板(PLT)、PLR显著高于非血栓组,淋巴细胞(LYM)计数显著低于非血栓组(P<0.05)。PLR预测DSA引导下肺癌患者PICC-UEVT的曲线下面积(95%CI)为0.910(0.870~0.953),显著高于PLT、LYM计数单独预测的0.847(0.796~0.895)、0.753(0.702~0.804)(Z=8.328、9.741,P<0.001)。血栓组患者年龄、身体质量指数及糖尿病、置管前D-二聚体≥0.5 mg/L、日常生活活动能力(ADL)评分<65分的患者占比均显著高于非血栓组(P<0.05)。多因素分析显示,糖尿病(OR=2.392,95%CI:1.417~4.036)、置管前D-二聚体≥0.5 mg/L(OR=2.818,95%CI:1.408~5.640)、ADL评分<65分(OR=2.356,95%CI:1.421~3.907)、PLR≥203.82(OR=2.779,95%CI:1.458~5.295)是DSA引导下肺癌患者PICC-UEVT的独立危险因素(P<0.05)。结论PLR升高与DSA引导下肺癌患者PICC-UEVT密切相关,且具有较好的预测效能。
Objective To explore the predictive value of the platelet-to-lymphocyte ratio(PLR)for peripherally inserted central catheter-associated upper extremity venous thrombosis(PICC-UEVT)in lung cancer patients under digital subtraction angiography(DSA)guidance.Methods A total of 160 lung cancer patients treated at the Affiliated Gaochun Hospital of Jiangsu University from January 2022 to February 2025 were selected.According to the occurrence of PICC-UEVT,the patients were divided into a thrombosis group(n=36)and a non-thrombosis group(n=124).The receiver operating characteristic curve was constructed to evaluate the predictive value of PLR for PICC-UEVT in lung cancer patients under DSA guidance.Multivariate logistic regression analysis was used to analyze the influencing factors for PICC-UEVT in these patients.Results The platelet count(PLT)and PLR in the thrombosis group were significantly higher than those in the non-thrombosis group,while the lymphocyte count(LYM)was significantly lower(P<0.05).The area under the curve(95%CI)of PLR for predicting PICC-UEVT was 0.910(0.870–0.953),which was significantly higher than that of PLT alone 0.847(0.796–0.895)and LYM count alone 0.753(0.702–0.804)(Z=8.328,9.741,P<0.001).The age,body mass index,and the proportions of patients with diabetes,pre-catheterization D-dimer≥0.5 mg/L,and activities of daily living(ADL)score<65 were all significantly higher in the thrombosis group than in the non-thrombosis group(P<0.05).Multivariate analysis showed that diabetes(OR=2.392,95%CI:1.417–4.036),pre-catheterization D-dimer≥0.5 mg/L(OR=2.818,95%CI:1.408–5.640),ADL score<65(OR=2.356,95%CI:1.421–3.907),and PLR≥203.82(OR=2.779,95%CI:1.458–5.295)were independent risk factors for PICC-UEVT in lung cancer patients under DSA guidance(P<0.05).Conclusion Elevated PLR is closely related to PICC-UEVT in lung cancer patients under DSA guidance and demonstrates good predictive efficacy.
作者
赵伟佳
赵静
肖月兰
李文珍
孔南芳
房新建
杨亮
ZHAO Weijia;ZHAO Jing;XIAO Yuelan;LI Wenzhen;KONG Nanfang;FANG Xinjian;YANG Liang(Department of Oncology,Gaochun Hospital Affiliated to Jiangsu University(Nanjing Gaochun People's Hospital),Nanjing 211300,China;Department of Interventional Therapy,Gaochun Hospital Affiliated to Jiangsu University(Nanjing Gaochun People's Hospital),Nanjing 211300,China)
出处
《转化医学杂志》
2026年第3期436-440,共5页
Translational Medicine Journal
基金
江苏大学2023年度医教协同创新基金一般项目(JDYY2023030)
江苏省“六大人才高峰”高层次人才资助项目(YY-188)。
